Were Low-T ads 'disease mongering'? Two experts say yes

A couple of geriatrics experts have joined the chorus of recommendations against testosterone therapy. But they're going a step further. They say drugmakers' enthusiastic advertising--which happened to be effective, too--was actually disease-mongering.

Dr. Thomas Perls

In an editorial in the Journal of the American Geriatrics Society, Dr. Thomas Perls and David Handelsman cite some impressive sales stats to back up their case: testosterone sales grew from $324 million in 2002 to $2 billion in 2012, with half a billion doses prescribed that year. "[S]ophisticated mass marketing" helped fuel that growth, the authors state. And they single out consumer advertising--with its "catchy medicalized sounding syndromes" such as Low-T and "andropause"--as a particular culprit.

DTC advertising "is the mass marketing component of disease mongering of age-related declines in testosterone," the authors write, helpfully defining disease-mongering as "the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments."

Obviously, given the sales stats, the market for testosterone therapies has grown. But as the market has grown, so have reports of serious side effects. Recent studies suggested that the testosterone meds could increase the risk of heart attack and other cardiovascular problems. And as of March 4, the FDA has officially warned against casual use of the meds, citing heart attack and stroke risks. Testosterone therapies, such as AbbVie's ($ABBV) Androgel and Eli Lilly's ($LLY) Axiron, should only be used for patients with clinically low testosterone levels, the agency says.

AbbVie and its rivals have backed off of advertising as the safety questions came to a head last year, Forbes notes. Lilly, for one, says that it's no longer airing TV ads for Axiron. But before that, the drugmakers were spending big bucks to promote those meds. AbbVie spent $75.6 million on DTC marketing in 2012 and $67.9 million in 2013, Forbes says, citing Kantar Media figures.

Those numbers fell last year, with Lilly and AbbVie together spending just $75 million on advertising testosterone therapies, Forbes says. AbbVie and Lilly maintain that their marketing educates consumers responsibly, and point out that the ads comply with FDA rules.

That's still too much advertising, Perls tells the publication. He and Handelsman contend that the FDA and Federal Trade Commission should ban ads for "contrived" conditions such as Low-T and "andropause."

"Normally the FDA does not allow advertising of products for indications that they have not approved," Perls says. "The FDA has said aging is not an indication. Well let's take that a step further and say you can't advertise testosterone for something called Low-T. That's not an approved indication."

- read the Geriatrics journal article
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